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HomeMy WebLinkAboutInsurance Certificate: OnTrack Inc (2) 13 YYYY) A~ CERTIFICATE OF LIABILITY INSURANCE 5/3/2 D3/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: Debbie Light, CISR WC No Smith 6 Crakes Inc. PHONE (541) 687-2211 FqC . Isall 144-saga 58 W 11th Ave E-M0AIL ,debbie@smithandcrakes. corn 0 INSURERS AFFORDING COVERAGE NAIC4 Eugene OR 97401 INSURERA:Great American Assurance Co. INSURED INSURERB:SAIF Corporation OnTrack Inc INSURER C: 221 W Main INSURER D: INSURER E : Medford OR 97501 INSURER F: COVERAGES CERTIFICATE NUMBER:13/14 GL/Pro/Au/Wc/Um REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR POLICY EFF POLICY EXP LIMITS ADDL UBR INSR TYPE OF INSURANCE PC CYNUIBER MMICION Y MMIDDYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMA T RENTED 100,000 X COMMERCIALGENERALLUIBILITY PREMISES Eaecounence $ A CLAIMS-MADE OCCUR X PAC6536160 5/1/2013 /1/2014 MED EXP(Any one person) $ 5,000 X Professional Liability PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GENT AGGREGATE LIMIT APPLIES PER' PRODUCTS - COMPIOP AGG $ 3,000,000 [ j LOC $ X POLICY P AUTOMOBILE LIABILITY COMBINED Eaaccident SINGLE LIMIT 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED SCHEDULED X AP537426740 5/1/2013 5/1/2014 BODILY INJURY (Per accidenq $ AUTOS NAUTOS ON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS AUTOS Per accident $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCES 3,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE $ 3,000,000 DED X RETENTIONS 10,00 3070034 5/1/2013 5/1/2014 $ H WORKERS COMPENSATION X WC STATU- DTH- AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORJPARTNERIEXECUTIVE O NIA E.L. EACH ACCIDENT $ 500 000 OFHCERIMEMBER EXCLUDED? 1/2013 7/1/2014 (Mandatory in NH) 451050 / E.L. DISEASE -EA EMPLOYE $ 500 000 If yesdescribe under _ E.L DISEASE - POLICYLIMIT $ SDDyOD. DESCRIPTION OF OPERATIONS below T- DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) As respects all operations of the insured in accordance to policy terms and conditions. City of Ashland, its officers, and employees as additional insured. CERTIFICATE HOLDER CANCELLATION (541) 488-5311 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland IFINANCE DEPARTMENT AUTHORIZED REPRESENTATIVE 20 East Main Street Ashland, OR 97520 R Crawford, CPCU/DL~°"`~sTk HC~L~ ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD